My dubious relationship with the spleen goes waaayyy back to medical school anatomy days when I learnt that any mass of tissue that I had absolutely no idea what it was when placed on a tray in front of me was usually a spleen.

The spleen was equally mysterious to the medical profession in general for many years, as no-one was quite sure as to its function. It is now known to act as a reservoir for lymphocytes and so is vital in dealing with bacteraemias.

This battle will look at the 2 extremes of spleen: splenomegaly, and hyposplenism/post splenectomy.

2 weeks prior to splenectomy pneumoccal vaccine and HiB should be given; if the splenectomy is an emergency these should be given ASAP afterwards.Lifelong penicillin (or erythromycin if penicillin allergic) is then also needed.

Most common serious infections after splenectomy are from encapsulated organisms such as s.pneumoniae, h.influenzae and n.meningitidis.

Blood film after splenectomy shows:

Howell-Jolly bodies (=nuclear remnants in RBCs)

target cells

Pappenheimer bodies (=abnormal iron inside RBCs)

There is low IgM.

As well as hyposplenism being a problem post splenectomy, it can also occur in sickle cell disease, coeliac disease and myeloproliferative diseases

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About Me

UK junior doctor attempting to revise for MRCP whilst maintaining her sanity/free time for the things in life doctors know are actually luxuries, like sleeping and eating.
No responsibility taken for any inaccuracies contained within, and please be aware that as this blog will often be written in a sleep/glucose deprived state the potential for whoopsies is great.
If you want to email me with corrections/suggestions/offers of chocolate, please do so to: marietreasure7 (at) gmail.com